Jacqueline Gomez, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

280328 Issued in NY

Practice address

333 Crossways Park Dr
Woodbury, NY 11797-2066

Phone

(631) 321-3850

NPI assigned

Mar 15, 2021

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1821673435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BAKER CT UNIT 90",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115582269",
            "telephone_number": "516-993-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972066",
            "telephone_number": "631-321-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JACQUELINE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "280328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Goldblum, LCSW
• Jamie Goldstein, CCC-SLP, TSSLD
• Jeffrey Alan Goldstein, D.O.
• Melissa Beth Goldstein, LCSW
• Harvey G Goldwasser, DDS
• Josue E Gomez, AGNP-C
• Shirley Goodman, MD
• Stephanie Nicole Gordin, AGNP
• Lee Farrell Green, M.S.ED
• Greenberg Medical Services PC

• Licensed Practical Nurse in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.